OP0126 LONG-TERM FOLLOW UP OF ABATACEPT IN USUAL INTERSTITIAL PNEUMONIA ASSOCIATED TO RHEUMATOID ARTHRITIS. NATIONAL MULTICENTER STUDY OF 172 PATIENTS
Authors: B. Atienza-Mateo, A. Serrano-Combarro, N. Del-Val, L. Ibarrola Paino, I. Casafont-Solé, R. Melero, A. Pérez-Linaza, I. Serrano-García, S. Castañeda, R. Ortega Castro, J. Calvo Gutierrez, N. Mena-Vázquez, N. Vegas-Revenga, L. C. Domínguez-Casas, M. C. Osorio, E. Cañadillas, C. Peralta-Ginés, C. Delgado-Beltran, C. Díez, T. Pérez Sandoval, M. Retuerto-Guerrero, L. Pérez Albaladejo, R. López-Sánchez, M. G. Mazano, A. Brandy-Garcia, P. López Viejo, G. Bonilla, O. Maiz-Alonso, M. D. C. Carrasco Cubero, M. Garijo Bufort, M. Moreno, A. Urruticoechea-Arana, S. Ordoñez, C. González-Montagut Gómez, J. R. De Dios Jiménez de Aberásturi, F. Lozano Morillo, T. Vazquez Rodriguez, P. Carreira, J. M. Blanco, C. Fernández-Díaz, J. Loricera, I. Ferraz-Amaro, D. Ferrer, R. Blanco
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Interstitial lung disease (ILD) is a severe extra-articular manifestation of rheumatoid arthritis (RA). Usual interstitial pneumonia (UIP) is the most frequent, and severe ILD pattern in RA. Abatacept (ABA) has demonstrated effectiveness in RA-ILD during a 12-month period of treatment <b>[1-2].</b> <h3>Objectives</h3> To assess the effectiveness and safety of ABA in RA-ILD patients with radiological pattern of UIP during a long-term follow-up. <h3>Methods</h3> From a large observational multicenter study of 392 RA-ILD patients treated with ABA, we selected those with UIP. We analyzed from baseline the following outcomes: <b>a</b>) forced vital capacity (FVC), <b>b</b>) diffusing capacity of the lungs for carbon monoxide (DLCO), <b>c</b>) chest high resolution computed tomography (HRCT), <b>d</b>) dyspnea (modified Medical Research Council scale) and <b>e</b>) arthritis activity (DAS28-ESR). <h3>Results</h3> We included a total of 172 patients with UIP (91 women/81 men; mean age 66.9±10.1 years). Baseline demographic and clinical characteristics are shown in <b>Table 1</b>. The median ILD duration up to ABA initiation was relatively short, with a median of 11 [3-39] months. Mean baseline values of FVC and DLCO were &gt;80% and &gt;60%, respectively. During the follow-up, median of 24 [10-44] months, 70.2% and 66.9% of patients showed an improvement/ stabilization of FVC and DLCO, respectively. Evolution of these parameters along 48 months is displayed in <b>Figure 1</b>. Available chest HRCT images improved/ stabilized in 64.5% of patients. Stabilization or improvement of dyspnea was found in 78.6% of patients. The majority of patients showed articular remission or low activity (mean DAS28-ESR of 4.3±1.5 at baseline and 2.5±1.5 at 48 months). ABA was withdrawn in 39 (22.6%) patients due to ILD worsening (17), articular inefficacy (9), serious infections (7) and other causes (n=6, development of malignancy in 3, diagnosis of giant cell arteritis and change to tocilizumab in 1, and 2 deceases). <h3>Conclusion</h3> ABA shows a lasting effectiveness and safety in RA-ILD patients with UIP, the most aggressive pattern. <h3>References</h3> [1]<i>Rheumatology (Oxford).</i> 2020 Dec 1;59(12):3906-3916. doi: 10.1093/rheumatology/keaa621 [2]<i>Rheumatology (Oxford).</i> 2021 Dec 24;61(1):299-308. doi: 10.1093/rheumatology/keab317 <b>Acknowledgements: Members of the Spanish Collaborative Group of Abatacept in RA-ILD:</b> Luis Arboleya, Javier Narváez, Juan Carlos Fernández, Belén Miguel, Iván Cabezas, Andrea García Valle, Clara Aguilera, Susana Romero, Ignacio Villa, Sabela Fernández Aguado, Raquel Almodóvar, Clara Ojeda, Blanca García-Magallón, Antonio Juan Mas, Manuel J. Moreno, Ana Ruibal, Rosa Expósito, José Antonio Bernal, Evelin C. Cervantes, Sebastián Rodríguez-García, Raúl Castellanos-Moreira, Iván, Manuel Rodríguez Gómez, Eva Salgado, Enrique Raya, Pilar Morales, Lorena Expósito, Mª Noelia Álvarez Rivas, José Luis Andreu, Esther F. Vicente, Ana M. López-Robles, Mireia López-Corbeto, Cristina Hidalgo, Jesús C. Fernández-López, Alejandro Olivé, Samantha Rodríguez, Iñigo Hernández, Neus Quillis, Angel García-Aparicio, Sonia Castro-Oreiro, Julia Fernández-Melón, Paloma Vela, María C. Fito, Manuel Rodríguez-Gómez, Deseada Palma-Sánchez, Lorena Expósito, José María Andreu Ubero. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Belén Atienza-Mateo: None declared, Ana Serrano-Combarro: None declared, N. Del-Val: None declared, Libe Ibarrola Paino: None declared, Ivette Casafont-Solé: None declared, Rafael Melero: None declared, Alba Pérez-Linaza: None declared, Isabel Serrano-García: None declared, Santos Castañeda: None declared, Rafaela Ortega Castro: None declared, Jerusalem Calvo Gutierrez: None declared, Natalia Mena-Vázquez: None declared, Nuria Vegas-Revenga: None declared, Lucia C. Domínguez-Casas: None declared, Maria Camila Osorio: None declared, Elena Cañadillas: None declared, C. Peralta-Ginés: None declared, C. Delgado-Beltran: None declared, Carolina Díez: None declared, Trinidad Pérez Sandoval: None declared, M. Retuerto-Guerrero: None declared, Lorena Pérez Albaladejo: None declared, R. López-Sánchez: None declared, Mª Guadalupe Mazano: None declared, Anahy Brandy-Garcia: None declared, Patricia López Viejo: None declared, Gemma Bonilla: None declared, Olga Maiz-Alonso: None declared, Maria del Carmen Carrasco Cubero: None declared, Marta Garijo Bufort: None declared, Mireia Moreno: None declared, ANA URRUTICOECHEA-ARANA: None declared, Sergi Ordoñez: None declared, C. González-Montagut Gómez: None declared, Juan Ramón De Dios Jiménez de Aberásturi: None declared, Fernando Lozano Morillo: None declared, Tomas Vazquez Rodriguez: None declared, Patricia Carreira: None declared, J M Blanco: None declared, Carlos Fernández-Díaz: None declared, J. Loricera: None declared, Iván Ferraz-Amaro: None declared, Diego Ferrer: None declared, Ricardo Blanco Speakers bureau: Abbvie, Pfizer, Roche, Lilly, Bristol-Myers, Janssen, Galapagos and MSD, Consultant of: Abbvie, Pfizer, Roche, Lilly, Bristol-Myers, Janssen and MSD, Grant/research support from: Abbvie, MSD, Novartis and Roche.